NEAR INFRARED SPECTROSCOPY FOR HEMODYNAMIC MONITORING IN NEONATES UNDERGOING

这个子项目是许多利用资源的研究子项目之一 由NIH/NCRR资助的中心拨款提供。子项目的主要支持 而子项目的主要调查员可能是由其他来源提供的， 包括其它NIH来源。 列出的子项目总成本可能 表示子项目使用的中心基础设施的估计数量， NCRR赠款不直接向子项目或子项目工作人员提供资金。 体外膜肺氧合（ECMO）是一种公认的治疗新生儿危及生命的条件，如疝气，新生儿肺动脉高压和严重的先天性心脏病。 这些患者在ECMO期间存在脑灌注受损和/或发生肾衰竭的风险。 这些患者的组织灌注疗效通过各种间接手段（组织乳酸含量、酸中毒、血气参数等）进行评估。 本观察性研究的主要目的是评估单侧大脑半球可能受损时（即单侧颈动脉结扎或大静脉插管）的双侧脑氧合。 此外，我们希望将血氧饱和度与短期和长期的神经发育结果联系起来，并将肾血氧饱和度与ECMO相关肾功能衰竭的发生率联系起来。 近红外光谱（NIRS）是一种非侵入性技术，可用于计算某些组织中的血氧饱和度。 局部脑氧饱和度指数（rSO 2 i）表示脑某些区域中动脉、小静脉和毛细血管的氧饱和度的加权平均值。 我们将使用这项技术来监测我们的患者从出生到ECMO的脑血氧饱和度，当他们在ECMO上时，在任何手术修复缺陷期间（无论当时是否在ECMO上），以及当患者正在脱离ECMO时。 还将从未进行ECMO的ECMO候选新生儿对照组中收集NIRS数据。 在患者康复后，脱离机械通气，并且进展良好，通常在出院前进行脑部MRI。 将分析这些MRI的结果以及在6个月和1岁时进行的神经系统和神经发育检查的结果。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Extracorporeal membrane oxygenation (ECMO) is an accepted therapy for newborns with life-threatening conditions such as diaphragmatic hernia, pulmonary hypertension of the newborn and severe congenital heart disease. These patients are at risk of compromised cerebral perfusion and/or of developing renal failure during ECMO. The efficacy of tissue perfusion in these patients is estimated by a variety of indirect means tissue lactate content, acidosis, blood gas parameters, etc. The primary purpose of this observational study is to assess bilateral cerebral oxygenation when one cerebral hemisphere is potentially compromised, i.e. unilateral carotid ligation or large venous cannula. Furthermore, we hope to relate oxygen saturation to short and long term neurodevelopmental outcomes and to relate renal oxygen saturation to incidence of ECMO related renal failure. Near-infrared spectroscopy (NIRS) is a non-invasive technique that can be used to compute the oxygen saturation for blood in certain tissues. The regional cerebral oxygen saturation index (rSO2i) represents the weighted average of the oxygen saturation of the arteries, venules, and capillaries in certain regions of the brain. We will use this technology to monitor the cerebral blood oxygen saturation of our patients from birth until they go on ECMO, while they are on ECMO, during any surgical repair of defects (whether on ECMO at the time or not), and while the patients are being weaned from ECMO. NIRS data will also be collected from a control group of ECMO candidate neonates that are not placed on ECMO. After the patients have recovered, are off of mechanical ventilation, and are progressing well, a brain MRI is typically performed prior to discharge. The findings of these MRIs as well as the findings of neurological and neurodevelopmental examinations made at six months and one year of age will be analyzed.